Last year, the Archive received a £35k grant from Archives Revealed, a funding partnership between The National Archives, Pilgrim Trust, and the Wolfson Foundation, to sort and catalogue the early records of St John Ambulance. In celebration of the Archives Revealed project, let’s look at the Order of St John’s creation of the St John Ambulance Association by exploring the national and international aid background in the years preceding its creation, the Order’s early ambulance work, and the eventual creation of the Association in 1877.
In the mid-1800s, there were no organised or well-established nursing systems for army casualties of war and no safe or protected institutions to treat the soldiers who became wounded on the battlefield. That began to change in 1863 when the International Committee for Relief to the Wounded (later known as the International Committee of the Red Cross) was founded. The Committee organised an international medical conference in Geneva to develop possible measures to improve battlefield medical services,
The final resolutions of the conference included five key points: the foundation of national societies to provide aid for wounded soldiers, neutrality and protection for wounded soldiers, the use of volunteer forces for the provision of battlefield relief assistance, the organisation of further conferences to enact and develop these concepts, and the introduction of a distinctive symbol to provide protection for medical personnel in the field – a red cross on a white background.
The conference was attended by 36 people from 14 nations, including the United Kingdom, and in the years following the conference, various National Societies for Aid to Sick and Wounded were set up across the world. The conference was attended by three members of the Order of St John in England who formed a Committee at a Chapter meeting of the Order in April 1869 to consider how a National Society could be set up in England. In the following year, the British National Society for Aid to the Sick and Wounded (later known as the British Red Cross Society) was founded, largely made up of Order members. Shortly after the British National Society’s foundation was the outbreak of the Franco-Prussian (or Franco-German) War, and the British Society organised a significant amount of voluntary aid for both the French and German sides, recruiting 200 surgeons, nurses, and other staff for the aid of the wounded soldiers.
At the Order’s AGM shortly after the war, papers on sanitary education and diet were read, identifying the Order’s continuing interest in aid, leading to the Order’s first attempts to establish ambulance training for laymen in collaboration with local London hospitals. But, as Nigel Corbett-Fletcher says in his history of St John’s Ambulance Department: “The records by their silence suggest that these attempts to promote lay instruction were not successful’. However, in March 1873, the Order initiated an Ambulance Department and Committee, and established Ambulance Stations in areas of mining and potteries. The Ambulance Stations were equipped with a two-wheeled litter and other ambulance equipment and were staffed by a trained ex-Army orderly.
Over the following years, further papers on aid, care, accidents, and injuries were read at Chapter meetings, including one lengthily titled paper ‘The Preliminary Care and Attention necessary for Accidental Bodily Injuries and Mutilations occurring in Mines and Establishments where many workpeople are employed’. This paper emphasised the need for trained people to be ready and able to respond to workplace injuries of these kinds and suggested that squads of five people from an Ambulance Corps should be trained, equipped, and ready at a moment’s notice, under the direction of a Committee of the Order of course. With the Order having established Ambulance Stations in areas of mining and potteries, it was already working to fulfil these needs.
At the end of 1874, the Order’s Ambulance Department agreed with Neuss, a Berlin-based manufacturer of litters, that their litters would be supplied by the Order throughout the UK. Within a year, a new and improved Neuss litter was patented under the name ‘St John Ambulance Litter’, with all rights to sale and manufacture secured by the Order, with the Order’s eight-pointed cross as the registered trademark for use on the litters. I believe this is the first time that the words ‘St John Ambulance’ were used, so we can perhaps see where the origins of the name ‘St John Ambulance’ began.
Illustrations of the Neuss ambulance litter, taken from the Order of St John’s 1874 Annual Report.
Illustrations of the “St. John” two-wheeled ambulance litter, taken from the Order of St John’s 1876 Annual Report.
When in 1876 war was declared between Turkey and Serbia and the British National Society took their time to respond to the battlefield needs for care of wounded soldiers, the Order, ever keen to be directly involved in aid, set up a committee to provide as much as it could towards battlefield aid. Acknowledging the possibility England could find itself engaged in war at some point in the future, the Order also began compiling a register of volunteers who were willing to undertake hospital service, should the occasion arise.
So far, I’ve briefly touched on nearly fifteen years of wars, increasing volunteer aid response, and rising interest in sanitation and health, all of which the Order of St John had a growing interest in. These events were the catalysts to the next big thing in St John’s history: the creation of the St John Ambulance Association. The Association was finally formed on 1st July 1877 in the words of Sir John Furley “as the direct outcome of enthusiasm evoked in 1870-1871 during the Franco-German War and of the efforts then made on a stupendous scale in favour of the sick and wounded in time of war, which it thought should be sustained for the benefit of civilians in time of peace”.
The foundation of the Association was largely due to the efforts of Order members Sir John Furley, Sir Edmund Lechmere, Major Francis Duncan, Sir Thomas Longmore, and Sir Edward Sieveking, as the British National Society did not, at the time, have the interest in training laypeople to tend to the sick and wounded, and this was a cause that the Order had become passionate about. The Association’s primary aims were to train laypeople in first aid skills and to share useful ambulance equipment. It began only with one triangular bandage, one stretcher, and one wheeled litter, and immediately introduced three lectures in first aid: the Junior Course, the First Aid Course, and the Nursing Course, providing certificates to those who passed their first aid courses. It is interesting to note that before the Association was formed, stretchers were practically unknown (except for in the Army and hospitals) so this was quite possibly the first time that laypeople would have seen such equipment.
To form an Association Centre, an influential local Committee (comprised of a Chairman, Treasurer, and Honorary Secretary) had to be set up. The Committee were required to secure the services of a competent medical gentleman to undertake the duties of Lecturer and to obtain the use of a suitable room (such as a schoolroom) where classes could be held. Classes could then be formed for men and women (separately of course), and if required, a Ladies Committee could be set up. The Committee also had to ensure the financial stability of their Centre and to contribute to the future of the Association, by organizing the collection of financial subscriptions to cover local expenses and contribute to the Association’s headquarters. Finally, the Committee had to maintain a register of names of certified pupils in first aid who would consent to assist the Order during wartime in the provision of first aid.
Within six months, the Association opened twelve Centres across the length and breadth of the country and provided 1,100 women and men with first aid skills. The first Centre was in Woolwich, where Surgeon-Major Peter Shepherd (a member of the Army Medical Department) gave the first course of lectures. The Association also became firmly established in the mining areas of Nottingham and Derbyshire almost immediately, with Centres formed at Clay Cross, Tibshelf, Blackwell and others. The first Ambulance Class for Railwaymen was initiated at the Great Western Railway in Paddington, and the first Ambulance Class for Policemen was initiated at Scotland Yard.
Tibshelf Colliery St John Ambulance Association Members, c. 1877 (Ref: A611)
In October 1878, the Association published its inaugural first aid manual, ‘Handbook Describing Aids for Cases of Injuries and Sudden Illness’ by Surgeon-Major Peter Shepherd, designed for use in its classes, for the Metropolitan Police, and by the Order across England. This publication set out the standard of training and followed the syllabus of its classes so that the same information could be accessed by all, and 20,000 copies were sold within the first 18 months of its publication.
Handbook Describing Aid for Cases of Injuries or Sudden Illness, 1878
1879 was a busy year for the Association. It created the Association’s first Ambulance Corps at the Margate Centre to transport patients around Kent, the Stores Depot opened at St John’s Gate to sell first aid equipment and manuals, and the first Ambulance hamper was created, fitted with a waterproof cover and containing splints, bandages, plaster, and other things ‘for the use of railways, fire brigades, and other establishments where many hands are employed’, and in May, the Association had its first royal recognition when the Duke of Edinburgh and Prince Leopold accepted posts as Presidents of two Association Centres.
By June of 1879, the Metropolitan Police had acknowledged the work that the Association was doing and the worth of its work and issued an order that all offers of assistance by certificated first aiders to persons injured in the streets of London should be accepted, and, that if the offer was not accepted by the injured party, a report should be made to the Police giving the reason for its non-acceptance. This was a huge recognition of volunteer first aid.
The order issued by the Metropolitan Police.
As well as awarding certificates to those who passed the Association’s courses, medallions were introduced as an award to certificated individuals who completed first aid re-examination. The need to re-certify in first aid was a recognition that knowledge and training around first aid was developing and that the training had to continue for it to be effective.
I’ve only scratched the surface of the Association’s early beginnings and there is so much more to know, so to close this blog here are some words from an 1878 report on the St John Ambulance Association:
‘In looking back on the six months preceding the date of this Report, the Committee can point with pride to the amount of earnest work done, and the amount of interest which it has created. At least 1,100 people are now skilled in handling the injured; and the power of relieving pain and saving life which is implied in that fact is enormous. Month by month, the wave of this simple but most effacious knowledge is spreading. It is reaching all grades of society, all ages, and all professions. It is humanising men: it gives the skill which follows upon knowledge, and the nerve which follows on skill: and in making men acquainted with sufferings which they themselves may never have experienced or seen, it softens their hearts, awakens their sympathies, and excites their courage’.